title: Clinical, electrocardiographic, echocardiographic characteristics and long-term follow-up of elite soccer players with J-point elevation.
abstract: BACKGROUND
  J-point elevation is common in athletes; nevertheless, the influence of structural changes associated with the athlete's heart and its prognostic impact are still debated. Our aim was to investigate the prevalence of J-point elevation, the associated clinical, electrocardiographic, and echocardiographic characteristics and its impact on long-term outcome in elite soccer players.
  
  
  RESULTS
  Clinical, electrocardiographic, and cardiopulmonary exercise test data from 332 male professional soccer players were retrospectively analyzed. For 235 (70.7%) athletes echocardiographic data were also available. J-point elevation was defined as an elevation ≥1 mm in ≥2 contiguous leads. Long-term follow-up data were obtained for all athletes, whereas univariate and multivariable analyses were performed to assess the associated characteristics. Overall, 118 (35.6%) athletes showed a J-point elevation ≥1 mm. At multivariable analysis a significant direct association of interventricular septum thickness (odds ratio for 1 SD increase, 1.361; 95% confidence interval, 1.019-1.817; P=0.036) and Sokolow-Lyon index (odds ratio for 1 SD increase, 1.367; 95% confidence interval, 1.026-1.822; P=0.033) and an inverse association of baseline heart rate (odds ratio for 1 SD increase, 0.686; 95% confidence interval, 0.508-0.927; P=0.011) with J-point elevation were observed. During a long-term follow-up (median, 13.3 years; first and third quartiles, 10.1-17.0 years), a low mortality rate was observed, not related to cardiovascular causes.
  
  
  CONCLUSIONS
  The correlation between J-point elevation and interventricular septum thickness suggests a possible mechanistic role of exercise-induced left ventricular hypertrophy as the basis for J-point elevation. After a long-term follow-up, no cardiac death was observed.
authors.affiliation: Division of Cardiology, Department of Medical Science, Città della Salute e della Scienza University of Torino, Turin, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Biasco
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Cristoforetti
authors.forename: Davide
authors.initials: D
authors.lastname: Castagno
authors.forename: Carla
authors.initials: C
authors.lastname: Giustetto
authors.forename: Piero
authors.initials: P
authors.lastname: Astegiano
authors.forename: Gianpasquale
authors.initials: G
authors.lastname: Ganzit
authors.forename: Carlo Gabriele
authors.initials: CG
authors.lastname: Gribaudo
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012916:Soccer; D020257:Ventricular Remodeling / Q000502:physiology; D055815:Young Adult
keywords: death, sudden; electrocardiography; electrophysiology; exercise